Summary

As payers seek partnerships with a narrower group of providers who can deliver real value, providers must take on greater financial risk and demonstrate continuous improvements in patient outcomes. New risk models can lead to increased reward, but are also fraught with danger for all parties in the movement toward value-based care (VBC).

The value-based way of operating is not new but it is still uncomfortable for many. Transitioning from the fee-for-service (FFS) model to VBC will be difficult as providers have focused on maximizing procedure volume and reimbursement pricing and not on care coordination. Many providers simply do not know how to proceed or where to focus their efforts.

In this Executive Insights, L.E.K. discusses key success factors that should be considered before going forward with a new value-based model.